Sleep Curriculum, 2009
Program Director: Charles Atwood, MD, FCCP, FAASM
Faculty and preceptors:
Patrick Strollo, MD, FCCP, FAASM (pulmonary)
David Kristo, MD, FCCP, FAASM (pulmonary)
Rachel Givelber, MD, FCCP, D.ABSM (pulmonary)
Daniel Buysse, MD, FAASM (psychiatry)
Sangeeta Chakravorty, MD, FAASM (pediatrics)
Wendy Troxel, PhD (psychology)
Asim Roy, MD, FAASM (neurology)
Volunteer faculty (at VA):
Eric Nofzinger, MD, D. ABSM (psychiatry)
Sarita Kumari, MD, FCCP, FAASM (pulmonary)
Executive committee:
Drs. Atwood, Strollo, Buysse, Kristo, Chakravorty
Administrative support: Ms. Patricia Geraci
GOAL
The goal of the Sleep Medicine fellowship-training program is to provide outstanding clinical training in all aspects of Sleep Medicine.
Contents
Clinical Training
- Outpatient Rotations
- UPMC Sleep Medicine Center
- Children’s Hospital of Pittsburgh
- VA Pittsburgh Healthcare System
- Other Rotations
- Psychiatric sleep disorders clinic
- Electives
- Inpatient Consults
Conferences
- Clinical case conference
- Journal Club
- Curriculum conference
- Sleep grand rounds/research conference
OUTPATIENT ROTATIONS
UPMC Sleep Medicine Center clinic
Clinic director: Dr. Kristo
Preceptors: Dr. Strollo, Dr. Atwood, Dr. Kristo, Dr. Givelber
Time Commitment: Tuesday ½ day every week for 12 months;
Monday ½ day every week for 6 months
Patient Characteristics and Diseases:
Patients seen in this clinic have a wide variety of sleep disorders including sleep disordered breathing, insomnia, circadian rhythm disorders, narcolepsy, restless legs syndrome, idiopathic hypersomnia and parasomnias.
Teaching Methods:
- Exposure of the fellow to a large number of sleep disorders, with follow-up over a period of 1 year
- Supervision and teaching by the attending physicians
Educational Purposes:
- To provide clinical experience in the outpatient assessment, diagnosis, and management of common and uncommon adult sleep disorders;
- To provide continuity of care and long-term follow-up of patients with these sleep disorders.
Educational Objectives: During this 1 year continuity experience, the trainee is expected to progressively increase his/her ability to:
Patient Care
- Gather accurate and essential historical information
- Perform a complete and accurate physical examination
- Generate an effective differential diagnosis
- Make decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence, and clinical judgment
- Develop and carry out patient management plans
- Communicate effectively and demonstrate caring and respectful behaviors when interacting with patients and their families
- Counsel and educate patients and their families
- Work effectively with other members of the health care team
- Assess and manage patients with a wide variety of sleep disorders, including:
- Obstructive sleep apnea
- Central sleep apnea
- Upper airway resistance syndrome
- Complex sleep apnea
- Narcolepsy
- Restless legs syndrome
- Parasomnias
- Idiopathic hypersomnia
- Circadian sleep disorders (advanced and delayed types)
- Jet lag
- Insomnia disorders
- Sleepiness in other medical disorders
- Sleepiness in psychiatric disorders
Medical Knowledge
- Understand basic and clinical sciences (especially physiology, pathophysiology, and pharmacology) as they relate to sleep medicine.
Practice-Based Learning and Improvement
- Analyze own practice for needed improvements
- Base medical decisions on “best evidence” available
- Efficiently and effectively search the medical literature
- Use information technology to support self-education
Interpersonal and Communication Skills
- Create and maintain a therapeutic relationship with patients
- Communicate in a caring and effective way with patients and family members
- Communicate with and work closely with nurses, sleep laboratory technologists, pharmacists, home care companies, and other members of the health care team
Professionalism
- Treat patients and family members with compassion and respect
- Treat nurses, sleep lab technologists, and other members of the health care team with respect
- Demonstrate sensitivity and responsiveness to a diverse patient population
Systems-Based Practice
- Work effectively with primary nurses, social workers, and case managers to optimize patient care
- Practice cost-effective health care
- Understand the interaction between one’s own practice and the larger health care system
- Act as an advocate for quality patient care
Standards of Performance:
- During this rotation the trainee is expected to
- Attend the UPMC Sleep Medicine clinic every week throughout the year.
- Present all new and complex return visits to the clinic attending staff.
Assessment:
- Performance assessment twice a year by the UPMC Sleep Medicine clinic faculty, clinic staff, sleep laboratory staff, and patients based on the educational objectives listed above.
- Fellows evaluate the clinic attending physicians and the educational value of the rotation twice a year.
VA Pittsburgh Healthcare System Sleep Disorders Clinic and Laboratory
Clinic director: Dr. Atwood
Preceptors: Dr. Atwood, Dr. Nofzinger, Dr. Kumari
Time Commitment: Clinic 1 ½ day every week for 12 months;
Clinic 2 ½ day every week for 6 months
Patient Characteristics and Diseases:
Patients seen in this clinic have a wide variety of sleep disorders including sleep disordered breathing, insomnia, circadian rhythm disorders, narcolepsy, restless legs syndrome, idiopathic hypersomnia and parasomnias. Patients with PTSD are seen with more frequency in the VA clinic compared to the UPMC sleep clinic.
Teaching Methods:
- Exposure of the fellow to a large number of sleep disorders, with follow-up over a period of 1 year
- Supervision and teaching by the attending physicians
Educational Purposes:
- To provide clinical experience in the outpatient assessment, diagnosis, and management of common and uncommon adult sleep disorders;
- To provide continuity of care and long-term follow-up of patients with these sleep disorders.
Educational Objectives:
- During this 1 year continuity experience, the trainee is expected to progressively increase his/her ability to:
Patient Care
- Gather accurate and essential historical information
- Perform a complete and accurate physical examination
- Generate an effective differential diagnosis
- Make decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence, and clinical judgment
- Develop and carry out patient management plans
- Communicate effectively and demonstrate caring and respectful behaviors when interacting with patients and their families
- Counsel and educate patients and their families
- Work effectively with other members of the health care team
- Assess and manage patients with a wide variety of sleep disorders, including:
- Obstructive sleep apnea
- Central sleep apnea
- Upper airway resistance syndrome
- Complex sleep apnea
- Narcolepsy
- Restless legs syndrome
- Parasomnias
- Idiopathic hypersomnia
- Circadian sleep disorders (advanced and delayed types)
- Insomnia disorders
- Sleepiness in other medical disorders
- Sleepiness in psychiatric disorders
Medical Knowledge
- Understand the basic and clinical sciences (especially physiology, pathophysiology, and pharmacology) as they relate to sleep medicine.
Practice-Based Learning and Improvement
- Analyze own practice for needed improvements
- Base medical decisions on “best evidence” available
- Efficiently and effectively search the medical literature
- Use information technology to support self- education
Interpersonal and Communication Skills
- Create and maintain a therapeutic relationship with patients
- Communicate in a caring and effective way with patients and family members
- Communicate with and work closely with nurses, sleep laboratory technologists, pharmacists, home care companies, and other members of the health care team
Professionalism
- Treat patients and family members with compassion and respect
- Treat nurses, sleep lab technologists, and other members of the health care team with respect
- Demonstrate sensitivity and responsiveness to a diverse patient population
Systems-Based Practice
- Work effectively with primary nurses, social workers, and case managers to optimize patient care
- Practice cost-effective health care
- Understand the interaction between one’s own practice and the larger health care system
- Act as an advocate for quality patient care
Standards of Performance:
- During this rotation the trainee is expected to
- Attend the VA clinic every week throughout the year.
- Present all new and complex return visits to the clinic attending staff.
Assessment:
- Performance assessment twice a year by the VAMC clinic faculty, clinic staff, sleep laboratory staff, and patients based on the educational objectives listed above.
- Fellows evaluate the clinic attending physicians and the educational value of the rotation twice a year.
Children’s Hospital of Pittsburgh Sleep Disorders Clinic
Preceptors: Dr. Chakravorty
Time Commitment: ½ day every week for 6 months
Patient Characteristics and Diseases:
Patients seen in this clinic are children and adolescents. They present with a wide variety of sleep disorders including sleep disordered breathing, insomnia, circadian rhythm disorders, narcolepsy, restless legs syndrome, and parasomnias.
Teaching Methods:
- Exposure of the fellow to a large number of sleep disorders, with follow-up over a period of ½ year
- Supervision and teaching by the attending physicians
Educational Purposes:
- To provide clinical experience in the outpatient assessment, diagnosis, and management of common and uncommon pediatric sleep disorders;
- To provide continuity of care and long-term follow-up of patients with these sleep disorders.
Educational Objectives:
- During this ½ year continuity experience, the trainee is expected to progressively increase his/her ability to:
Patient Care
- Gather accurate and essential historical information
- Perform a complete and accurate physical examination
- Generate an effective differential diagnosis
- Make decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence, and clinical judgment
- Develop and carry out patient management plans
- Communicate effectively and demonstrate caring and respectful behaviors when interacting with patients and their families
- Counsel and educate patients and their families
- Work effectively with other members of the health care team
- Assess and manage patients with a wide variety of sleep disorders, including:
- Obstructive sleep apnea
- Central sleep apnea
- Upper airway resistance syndrome
- Complex sleep apnea
- Narcolepsy
- Restless legs syndrome
- Parasomnias
- Circadian sleep disorders (advanced and delayed types)
- Insomnia disorders
- Sleepiness in other medical disorders
- Sleepiness in psychiatric disorders
Medical Knowledge
- Understand the basic and clinical sciences (especially physiology, pathophysiology, and pharmacology) as they relate to pediatric sleep medicine.
Practice-Based Learning and Improvement
- Analyze own practice for needed improvements
- Base medical decisions on “best evidence” available
- Efficiently and effectively search the medical literature
- Use information technology to support self- education
Interpersonal and Communication Skills
- Create and maintain a therapeutic relationship with patients
- Communicate in a caring and effective way with patients and family members
- Communicate with and work closely with nurses, sleep laboratory technologists, pharmacists, home care companies, and other members of the health care team
Professionalism
- Treat patients and family members with compassion and respect
- Treat nurses, sleep lab technologists, and other members of the health care team with respect
- Demonstrate sensitivity and responsiveness to a diverse patient population
Systems-Based Practice
- Work effectively with primary nurses, social workers, and case managers to optimize patient care
- Practice cost-effective health care
- Understand the interaction between one’s own practice and the larger health care system
- Act as an advocate for quality patient care
Standards of Performance:
- During this rotation the trainee is expected to
- Attend the Children’s Hospital sleep disorders clinic every week throughout the year.
- Present all new and return visits to the clinic attending staff.
Assessment:
- Performance assessment of the fellows by the attending physician staff.
- Fellows evaluate the clinic attending physicians and the educational value of the rotation at the end of the rotation.
Other outpatient experiences
Insomnia / Behavioral Sleep Medicine
Clinic leader: Dr. Buysse
Preceptors: Dr. Buysse, Dr. Troxel
Time Commitment: ½ day every week for 3 months
Patient Characteristics and Diseases:
Patients seen in this clinic are adolescents and adults. They present with a wide variety of sleep disorders including, insomnia, circadian rhythm disorders, narcolepsy, and parasomnias. The main focus of this clinic experience is patients with insomnia and other disorders requiring behavioral and/or pharmacologic management.
Teaching Methods:
- Exposure of the fellow to management of non-pulmonary sleep disorders.
- Supervision and teaching by the attending physicians and psychologists
Educational Purposes:
- To provide clinical experience in the outpatient assessment, diagnosis, and management of non-pulmonary sleep disorders, especially insomnia.
Educational Objectives:
- During this 3 month experience, the trainee is expected to progressively increase his/her ability to:
Patient Care
- Gather accurate and essential historical information
- Perform a complete and accurate physical examination
- Generate an effective differential diagnosis
- Make decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence, and clinical judgment
- Develop and carry out patient management plans
- Communicate effectively and demonstrate caring and respectful behaviors when interacting with patients and their families
- Counsel and educate patients and their families
- Work effectively with other members of the health care team
- Assess and manage patients with a wide variety of sleep disorders, including:
- Insomnias
- Parasomnias
- Narcolepsy
- Circadian sleep disorders (advanced and delayed types)
- Jet lag
- Other sleep disorders characterized by hypersomnia
Medical Knowledge
- Understand the basic and clinical sciences (especially physiology, pathophysiology, pharmacology, and psychology) as they relate to sleep medicine.
Practice-Based Learning and Improvement
- Analyze own practice for needed improvements
- Base medical decisions on “best evidence” available
- Efficiently and effectively search the medical literature
- Use information technology to support self-education
Interpersonal and Communication Skills
- Create and maintain a therapeutic relationship with patients
- Communicate in a caring and effective way with patients and family members
- Communicate with and work closely with nurses, sleep laboratory technologists, pharmacists, home care companies, and other members of the health care team
Professionalism
- Treat patients and family members with compassion and respect
- Treat nurses, sleep lab technologists, and other members of the health care team with respect
- Demonstrate sensitivity and responsiveness to a diverse patient population
Systems-Based Practice
- Work effectively with physicians, psychologists, primary nurses, social workers, and case managers to optimize patient care
- Practice cost-effective health care
- Understand the interaction between your practice and the larger health care system
- Act as an advocate for quality patient care
Standards of Performance:
- During this rotation the trainee is expected to
- Attend the Psychiatric sleep disorders clinic at times assigned during the year.
- Present all new and return visits to the clinic attending staff.
Assessment:
- Performance assessment of the fellows by the attending physician and psychologist staff.
- Fellows evaluate the clinic attending physicians and the educational value of the rotation at the end of the rotation.
Elective experiences
Electives can be performed depending on the interests of the fellow. Each rotation would be 1-3 months long. These are developed and subscribed to on a case-by-case basis.
Other outpatient experiences
Insomnia / Behavioral Sleep Medicine
Clinic leader: Dr. Buysse
Preceptors: Dr. Buysse, Dr. Troxel
Time Commitment: ½ day every week for 3 months
Patient Characteristics and Diseases:
Patients seen in this clinic are adolescents and adults. They present with a wide variety of sleep disorders including, insomnia, circadian rhythm disorders, narcolepsy, and parasomnias. The main focus of this clinic experience is patients with insomnia and other disorders requiring behavioral and/or pharmacologic management.
Teaching Methods:
- Exposure of the fellow to management of non-pulmonary sleep disorders.
- Supervision and teaching by the attending physicians and psychologists
Educational Purposes:
- To provide clinical experience in the outpatient assessment, diagnosis, and management of non-pulmonary sleep disorders, especially insomnia.
Educational Objectives:
- During this 3 month experience, the trainee is expected to progressively increase his/her ability to:
Patient Care
- Gather accurate and essential historical information
- Perform a complete and accurate physical examination
- Generate an effective differential diagnosis
- Make decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence, and clinical judgment
- Develop and carry out patient management plans
- Communicate effectively and demonstrate caring and respectful behaviors when interacting with patients and their families
- Counsel and educate patients and their families
- Work effectively with other members of the health care team
- Assess and manage patients with a wide variety of sleep disorders, including:
- Insomnias
- Parasomnias
- Narcolepsy
- Circadian sleep disorders (advanced and delayed types)
- Jet lag
- Other sleep disorders characterized by hypersomnia
Medical Knowledge
- Understand the basic and clinical sciences (especially physiology, pathophysiology, pharmacology, and psychology) as they relate to sleep medicine.
Practice-Based Learning and Improvement
- Analyze own practice for needed improvements
- Base medical decisions on “best evidence” available
- Efficiently and effectively search the medical literature
- Use information technology to support self-education
Interpersonal and Communication Skills
- Create and maintain a therapeutic relationship with patients
- Communicate in a caring and effective way with patients and family members
- Communicate with and work closely with nurses, sleep laboratory technologists, pharmacists, home care companies, and other members of the health care team
Professionalism
- Treat patients and family members with compassion and respect
- Treat nurses, sleep lab technologists, and other members of the health care team with respect
- Demonstrate sensitivity and responsiveness to a diverse patient population
Systems-Based Practice
- Work effectively with physicians, psychologists, primary nurses, social workers, and case managers to optimize patient care
- Practice cost-effective health care
- Understand the interaction between your practice and the larger health care system
- Act as an advocate for quality patient care
Standards of Performance:
- During this rotation the trainee is expected to
- Attend the Psychiatric sleep disorders clinic at times assigned during the year.
- Present all new and return visits to the clinic attending staff.
Assessment:
- Performance assessment of the fellows by the attending physician and psychologist staff.
- Fellows evaluate the clinic attending physicians and the educational value of the rotation at the end of the rotation.
Elective experiences
Electives can be performed depending on the interests of the fellow. Each rotation would be 1-3 months long. These are developed and subscribed to on a case-by-case basis.
INPATIENT CONSULTATIONS
UPMC and VA Inpatient Consultations
Time Commitment: Each fellow covers each facility for 6 months
Preceptors: Drs. Atwood, Strollo, Kristo, Givelber
Patient Characteristics and Diseases:
Most consultations are for sleep apnea related questions. Occasionally consults for other disorders are seen.
Procedural Skills:
Sleep study interpretation
Teaching Methods:
- Active participation in the assessment, diagnosis, and management of patients with a wide variety of sleep disorders
- Faculty teaching, both didactic and at the bedside
- Consult rounds are performed with the attending faculty physician.
Fellow Supervision:
The attending faculty physician is present to supervise the care provided by the fellow or is immediately available for consultation.
Educational Purposes:
- To provide clinical experience in the evaluation and management of adult patients with a wide range of sleep disorders.
- To provide experience in the assessment, testing and clinical management of inpatients with sleep disorders.
Educational Objectives:
- Throughout the first year of training, the fellow is expected to progressively increase his/her ability to:
Patient Care
- Gather accurate and essential historical information
- Perform a complete and accurate physical examination
- Accurately interpret sleep laboratory data
- Generate an effective differential diagnosis
- Make decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence, and clinical judgment
- Develop and carry out patient management plans
- Communicate effectively and demonstrate caring and respectful behaviors when interacting with patients and their families
- Counsel and educate patients and their families
- Work effectively with other members of the health care team
- Assess and manage patients with sleep disorders, including:
- Sleep apnea
- Excessive daytime sleepiness
- Narcolepsy
- Restless Legs Syndrome
Medical Knowledge
- Understand the basic sciences (especially physiology, pathophysiology, and pharmacology) and the clinical sciences as they relate to sleep medicine
Practice-Based Learning and Improvement
- Analyze own practice for needed improvements
- Base medical decisions on “best evidence”
- Efficiently and effectively search the medical literature
- Use information technology to support self-education
Interpersonal and Communication Skills
- Create and maintain a therapeutic relationship with patients
- Communicate in a caring and effective way with patients and family members
- Communicate with and work closely with nurses, respiratory therapists, pharmacists, and other members of the health care team
Professionalism
- Treat patients and family members with compassion and respect
- Treat nurses and other members of the health care team with respect
- Demonstrate sensitivity and responsiveness to a diverse patient population
Systems-Based Practice
- Work effectively with primary nurses, social workers, and case managers to optimize patient care
- Practice cost-effective health care
- Understand the interaction between one’s own practice and the larger health care system
- Act as an advocate for quality patient care
Fellow Responsibilities/Standards of Performance:
The expectations of the fellow assigned to this rotation are to:
- Perform a comprehensive, written consultation as soon as possible after notification of the request. Routine consults must be evaluated and staffed within 24 hours.
- Review with the attending and interpret any sleep studies that result from the consultation.
Assessment:
- At the end of each faculty rotation, the fellow is formally evaluated by the attending faculty physician.
- At the end of each rotation, the fellow formally evaluates the faculty member(s) and the educational quality of the rotation.
Conferences
Competencies assessed: medical knowledge, professionalism, systems-based practice, practice-based learning and improvement.
- Clinical case conference
- Occurs weekly for 1 hour. Recent patients of fellows and faculty are presented, sleep studies reviewed, and management discussed.
- Journal Club
- Occurs monthly for 1 hour. Each fellow presents one article of interest. Newer literature in different areas of sleep medicine is emphasized.
- Curriculum conference
- Occurs weekly for 1 hour. Curriculum topics are discussed by faculty and fellows. Presentations vary from Powerpoint-based lectures to seminar-style discussions of assigned readings.
- Sleep grand rounds/research conference
- Occurs weekly for 1 hour. Presentations are research or clinical update oriented.
- Research in progress. Occurs weekly at WPIC. Focuses on new or ongoing research. This conference is optional for clinical sleep medicine fellows.
Educational Standards: Fellows are expected to attend all conferences. They present cases at the clinical case conference weekly and give Sleep Grand Rounds twice per year.
Introductory Conferences
Fellows receive instruction in the core topics of sleep medicine in the first 2 weeks of their fellowship.
These topics are:
- Sleep apnea
- Insomnia
- Restless legs
- Pediatrics
- Neurological disorders
Sleep laboratory Competencies
During the first 2 months of the fellowship training, sleep medicine fellows complete 14 teaching modules that focus on sleep laboratory skills.
These include:
- Introduction to equipment and supplies
- Equipment cleaning
- General sleep lab duties (of technologists)
- Diagnostic study preparation
- Therapeutic studies
- Multiple Sleep Latency and Maintenance of Wakefulness Testing
- EEG 10-20 system
- Sleep EEG scoring
- Scoring of respiratory events
- Scoring arousals
- Portable sleep apnea testing tests
- Ventilator sleep studies
- Sleep medicine software – data acquisition and management
- Emergency information
- Actigraphy
EDUCATIONAL OBJECTIVES AND ASSESSMENT
A = attending CL = check list
N = nurse FC = fellowship committee
ST = sleep technologist
P = patient
OE = oral examination
CSR = chart stimulated recall
360 = 360 deg evaluation
Patient Care
| • |
Gather most essential historical information |
360(A),OE,CSR,FC |
| • |
Accurately interpret sleep studies of all types |
360(A),CSR,OE,WE,FC |
| • |
Generate a thoughtful and effective differential
diagnosis |
360(A),OE,CSR,FC |
| • |
Make decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence, and clinical judgment |
360(A),OE,CSR,FC |
| • |
Develop and carry out patient management plans with some faculty assistance |
360(A),CSR,FC |
| • |
Communicate effectively and demonstrate caring and respectful behaviors when interacting with patients and their families |
360(A,N,ST,P),FC |
| • |
Counsel and educate patients and their families |
360(A,N,ST,P),FC |
| • |
Work effectively with the health care team |
360(A,N,ST),FC |
| • |
Assess and manage, with some faculty assistance, outpatients and inpatients, with a wide variety of sleep disorders , including: |
360(A),CSR,OE,FC |
- Central sleep apnea
- Upper airway resistance syndrome
- Complex sleep apnea
- Narcolepsy
- Restless legs syndrome
- Parasomnias
- Idiopathic hypersomnia
- Circadian sleep disorders (advanced and delayed types)
- Insomnia disorders
- Sleepiness in other medical disorders
- Sleepiness in psychiatric disorders
Medical Knowledge
| • |
Have a good understanding of the basic sciences (especially physiology, pathophysiology, and pharmacology) and clinical sciences as they relate to sleep medicine |
360(A),CSR,OE,WE,P,FC |
| • |
Demonstrate a basic analytic approach to clinical problems |
360(A),CSR,OE,FC |
Practice-Based Learning and Improvement
| • |
Analyze own practice for needed improvements |
360(A),CSR,TR,FC |
| • |
Base medical decisions on “best evidence” |
360(A),CSR,OE,FC |
| • |
Efficiently and effectively search the medical
literature |
CSR,TR |
| • |
Apply basic knowledge of study designs and statistical methods to evaluate the strengths and weaknesses of research studies |
TR |
| • |
Use information technology to support their own education |
360(A),CSR,FC |
Interpersonal and Communication Skills
| • |
Create and maintain a therapeutic relationship with patients |
360(A,N,ST,P),FC |
| • |
Communicate in a caring and effective way with patients and family members |
360(A,N,ST,P),FC |
| • |
Communicate with and work closely with nurses, respiratory therapists, pharmacists, and other members of the health care team |
360(A,N,ST),FC |
| • |
Demonstrate basic skills to convey information in a public forum |
TR,FC |
Professionalism
| • |
Treat patients and family members with compassion and respect |
360(A,N,P),FC |
| • |
Treat nurses and other members of the health care team with respect |
360(A,N,ST),FC |
| • |
Demonstrate sensitivity and responsiveness to a diverse patient population |
360(A,N,P,ST),FC |
Systems-Based Practice
| • |
Work effectively with primary nurses, social workers, and case managers to optimize patient care |
360(A,N,ST),FC |
| • |
Practice cost-effective health care |
360(A),FC |
| • |
Understand the interaction between their practice and the larger health care system |
360(A),FC |
| • |
Act as an advocate for quality patient care |
360(A,N,P),FC |